November 20, 2020 3 min read

eSports athletes spend most of their time practicing and preparing for huge competitions and, like in any other sports, can cause a variety of injuries and aches, more particularly in the hands and wrists due to frequent hand motions required for each game. Some gamers often deal with thumb pain after countless hours with the console, which can be very disabling and can really cause a game due to severe discomfort. Continuous or too much use of the thumb with a console stick can result in thumb pain, known to the eSports world as the “Gamer’s Thumb.” But what exactly is a Gamer’s Thumb and how do eSports athletes deal with it?

The Gamer's Thumb

Gamer’s thumb in sports medicine is technically called De Quervain’s Tenosynovitis and is caused by inflammation of the tendons that move the thumb due to repetitive stress, resulting in pain along the outer side of the wrist. Gaming is a common cause, hence the name “Gamer’s Thumb,” but various terms are also tagged to it, such as Nintendo Thumb, Playstation Thumb, WASD Wrist, and Nintendonitis. Specifically, the tendons of abductor pollicis longus (APL) and extensor pollicis brevis (EPB) are affected. Although frequently seen in the gaming world, De Quervain’s Tenosynovitis can also develop in individuals who make use of their thumbs and wrists quite frequently, especially when it involves twisting motions, creating large amounts of strain that stress these tendons. The symptoms include:

  • Pain and swelling near or at the base of the thumb going up the wrist
  • Pain with thumb and wrist movement
  • Difficulty grasping or pinching
  • Pain when turning or flexing the wrist
  • Pain when making a fist

Treatment of Gamer's Thumb

De Quervain’s Syndrome can be challenging to treat. It is important that a gamer should stop playing once severe pain is felt so that aggravation of the condition is prevented. Remember that this can be very uncomfortable and debilitating and pushing yourself can really take a toll on the thumb and prevent an athlete from moving forward into the sport.

At the early stage of the condition or on flare-ups, immediately apply the RICE protocol (rest, ice, compression, and elevation principle) to minimize the inflammation. As an inflammatory condition, icing is critically important, especially if the thumb is swollen and very tender to touch. As the condition allows, gentle massage and stretching can commence. Exercise is the best treatment for tendon injuries like the Gamer’s Thumb, while others only offer temporary relief.

  • RICE protocol (Rest, Ice, Compression, and Elevation) on the acute stage.
  • Anti-inflammatory medications.
  • Physical therapy consisting of gentle stretching and strengthening exercises.


The goal of treatment for Gamer’s Thumb is to break the adhesions that developed within the tendon sheath through cross fiber technique. If the spot is still tender to touch, icing can be done before soft tissue work to minimize discomfort and allow for deeper pressure and more effective mobilization.

  • Using the round head attachment for a more comfortable glide, apply cross fiber technique at a level-1 speed to the tendons on the thumb side of the wrist, moving side to side along the length of the tendons about the wrist. It is important to warm up the area with a gentler sweeping motion and then gradually transitioning toward deeper pressure techniques as the patient’s tolerance allows.

Precaution:avoid applying too much pressure at a spot just above the wrist on the outer side to avoid compressing the sensitive structures that pass through the “anatomical snuffbox,” such as the radial nerve, radial artery, and the cephalic vein.

  • A combination of longitudinal stripping, circular friction, compression broadening, and cross-fiber can works nicely on the muscle bellies on the forearm. Glide the gun over the outer side of the forearm in front using these techniques.
  • As the condition is beginning to resolve, stretching of the APL and EPB can be done. With the thumb bent across the palm and the fingers over the thumb, move the wrist towards your little finger. Hold for a few seconds before going back to the starting position. This is stretching is based on the Finkelstein test, a diagnostic maneuver for De Quervain's Syndrome where the presence of pain means a positive test.
  • After a session, it is beneficial to apply ice over the area for at least 5 minutes to minimize any inflammatory reaction to the workup.